Endoscopic Surgery

"New choices in craniosynostosis surgery: Less invasive, endoscopic craniosynostosis surgery"
NJ Craniofacial Center Team 2024

Endoscopic Craniosynostosis Surgery (endoscopic craniectomy)

Catherine Mazzola, MD, FAANS

Before 2002, no pediatric neurosurgeons were performing this procedure in New Jersey. In fact, most neurosurgeons had never even heard of this procedure in 2002. Children who had craniosynostosis were treated through a standard, open, cranial vault reconstruction. This surgery typically took four to six hours, and most children were in the hospital for approximately 5 to 8 days.

However, Dr. Mazzola ran into her friend Dr. David Jimenez at a national neurosurgical meeting that year and he invited her to San Antonio, TX, to learn how to do endoscopic craniosynostosis surgery. David had started performing craniosynostosis surgery through a minimally invasive approach with his wife, Dr. Constance M Barone. Doctor Barone was a plastic and craniofacial surgeon, and together, they had developed a minimally invasive procedure which reduced both the operative time and blood loss for infants who needed craniosynostosis surgery.

Through a small incision, a camera was placed under the skin and the abnormal bone bridge across the suture, which was the cause of the suture fusion, was carefully removed. Some of the surgeries were less than one-hour long period, some children went home after surgery, some children stayed overnight and rarely a child stays two nights in the hospital. Videos of the procedure, performed by Dr. Mazzola, can be accessed through our video library.

Dr. Catherine Mazzola did the first minimally invasive endoscopic strip craniectomy surgery in New Jersey in 2005. That procedure was first done only at Morristown Medical Center, and then she started doing this procedure at Hackensack Medical Center. Dr. Mazzola started the pediatric craniofacial center at Morristown and then later developed the New Jersey Craniofacial Center Team in Morristown.
The advantages of endoscopic surgery are multifold. The operative time is shorter, there is less blood loss and there is less need for transfusion. Additionally, the hospital stay is shorter and babies typically go home the day after surgery. The incision is smaller and more cosmetically appealing. The disadvantage is that the overall change in shape is not immediate. So, if there is significant restricted brain growth, macrocephaly or an elevated intracranial pressure, then the open, traditional surgery may be considered.
Dr. Daniel Pyo and I visited David and Connie in San Antonio and we spent time with them, reviewing their surgical technique and their follow-up data. The cosmetic results have been excellent. We started doing endoscopic craniosynostosis surgery through the NJ Craniofacial Center over a year ago. Parents couldn’t have been happier with the endoscopic surgery and the pediatricians have been amazed.
Parent satisfaction with both surgeries has been high. The cosmetic results have been excellent, as well.

For more about our craniosynostosis program, for questions or to make an appointment, please see the NJ Craniofacial Team website at www.njcraniofacialcenter.com or call 973-326-9009.

To watch a brief video about endoscopic craniosynostosis please view: http://www.youtube.com/watch?v=hDjYCyij3M4.

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